IJID regions最新文献_第2页

Epidemiology of hand, foot and mouth disease outbreaks in Sabah, Malaysia: One year cross-sectional study

IF 1.5 Q4 INFECTIOUS DISEASES

IJID regions

Pub Date : 2025-02-17 DOI: 10.1016/j.ijregi.2024.100543

Mei Yin Pong , Jun Fai Yap , Muhammad Jikal

Introduction

Hand, foot and mouth disease (HFMD) is a contagious illness typically caused by enteroviruses. However, the causative agent of HFMD can vary by type and region. To better understand the epidemiological characteristics, we conducted a retrospective study of HFMD outbreaks in a Malaysia state over the course of one year.

Material and Methods

A cross-sectional descriptive analysis was conducted on all notified HFMD outbreaks and confirmed HFMD cases within Sabah state in Malaysia via the national public health disease surveillance system. Clinical specimens (throat swabs, ulcer swabs, rectal swabs or stool cultures) taken during the outbreaks were tested by polymerase chain reaction and positivity yield rates were reported.

Results

A total of 215 HFMD outbreaks occurred predominantly in childcare centres (40.9%), involving 1232 cases in the state. The most commonly affected age group was children aged 0 to 4 years, with males accounting for 56.0% of the cases. The majority were of native ethnicity (76.4%), followed by Chinese ethnicity (8.6%). No fatalities were detected. Of the 485 clinical specimens sent, 41.0% tested positive for viruses, with stool cultures exhibiting the highest positivity rate. Among the positive specimens, 52.3% tested positive for PanEnterovirus, followed by Coxsackievirus A16 (24.6%) and Enterovirus 71 (23.1%). Further viral isolation tests on PanEnterovirus samples revealed that 1.9% were identified as Coxsackievirus A16.

Discussion

During outbreaks of HFMD in the Malaysia state, male children under the age of five were notably affected. It was reported that the duration of viral shedding lasted longer in stools compared to other swab samples, potentially leading to a higher diagnostic yield. The co-circulation of both Coxsackievirus A16 and Enterovirus 71 in the state highlights a potential risk to public health, emphasizing the importance of regular laboratory surveillance in the country.

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引用次数: 0

INFECTION 2024

IF 1.5 Q4 INFECTIOUS DISEASES

IJID regions

Pub Date : 2025-02-17 DOI: 10.1016/j.ijregi.2025.100575

Tsz Ho Kwan , Shui Shan Lee

引用次数: 0

Sexually transmitted infection test-and-treat

IF 1.5 Q4 INFECTIOUS DISEASES

IJID regions

Pub Date : 2025-02-17 DOI: 10.1016/j.ijregi.2024.100529

Ngai Sze Wong

Globally, the disease burden of sexually transmitted infections (STIs) has remained high over the years. Every day, more than 1 million STIs are acquired around the world. The negative impacts of STIs include morbid sexual and reproductive health, stigmatization, and congenital syphilis. Fortunately, most bacterial STIs (including syphilis, chlamydia, and gonorrhea) are curable, enabling test-and-treat as a useful approach for controlling the epidemics in people at high risk of infection. The 2022–2030 global health sector strategies have set the indicators of >90% screening coverage and >95% of treatment coverage for syphilis and gonorrhoea in priority population. Regular STI testing, usually referring to syphilis, chlamydia, and gonorrhea, in sexually active men who have sex with men (MSM) have been recommended in a few international STI guidelines. With advanced technology development, STI testing spectrum has been expanded, and the testing procedures have been simplified for point-of-care testing or even home-based self-testing. While regular specific STIs testing could be beneficial for key populations, the potential emergence of resistance resulting from selective pressure following intensive screening and treatment of some STI such as gonorrhoea is a concern. The strategy of testing could be the key, which may need to be optimised. New strategy from another approach such as vaccination are under development.

{"title":"Sexually transmitted infection test-and-treat","authors":"Ngai Sze Wong","doi":"10.1016/j.ijregi.2024.100529","DOIUrl":"10.1016/j.ijregi.2024.100529","url":null,"abstract":"<div><div>Globally, the disease burden of sexually transmitted infections (STIs) has remained high over the years. Every day, more than 1 million STIs are acquired around the world. The negative impacts of STIs include morbid sexual and reproductive health, stigmatization, and congenital syphilis. Fortunately, most bacterial STIs (including syphilis, chlamydia, and gonorrhea) are curable, enabling test-and-treat as a useful approach for controlling the epidemics in people at high risk of infection. The 2022–2030 global health sector strategies have set the indicators of >90% screening coverage and >95% of treatment coverage for syphilis and gonorrhoea in priority population. Regular STI testing, usually referring to syphilis, chlamydia, and gonorrhea, in sexually active men who have sex with men (MSM) have been recommended in a few international STI guidelines. With advanced technology development, STI testing spectrum has been expanded, and the testing procedures have been simplified for point-of-care testing or even home-based self-testing. While regular specific STIs testing could be beneficial for key populations, the potential emergence of resistance resulting from selective pressure following intensive screening and treatment of some STI such as gonorrhoea is a concern. The strategy of testing could be the key, which may need to be optimised. New strategy from another approach such as vaccination are under development.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"14 ","pages":"Article 100529"},"PeriodicalIF":1.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Factors associated with cryptococcal capsular antigen positivity among people living with HIV: A retrospective observational cohort study

IF 1.5 Q4 INFECTIOUS DISEASES

IJID regions

Pub Date : 2025-02-17 DOI: 10.1016/j.ijregi.2024.100532

Fenqi Da , Yi Cao , Pengle Guo , Yeyang Zhang , Yaozu He , Quanmin Li , Weiran Tan , Huijun Hou , Xiaoping Tang , Heping Zhao , Linghua Li

Introduction

Cryptococcosis, caused by Cryptococcus, is an aggressive fungal disease posing a high mortality risk among people living with HIV (PLHIV). However, factors associated with the prevalence of cryptococcal capsular antigen (CrAg) among PLHIV remain unclear.

Material and Methods

We recruited PLHIV from a designated HIV/AIDS clinic in Southern China between March 2018 and December 2019. Serum CrAg was qualitatively detected using Lateral Flow Assay (LFA). Fungal culture and pathological examinations were performed using the cerebrospinal fluid (CSF). Chi-squared test and multivariable logistic regression were utilized to assess factors associated with the prevalence of CrAg.

Results

A total of 1478 PLHIV were included, among whom 297 were antiretroviral therapy-naïve (ART-naïve), 1181 (79.9%) were ART-experienced. The median baseline CD4+ T cell count was 43 cells/µl (interquartile range [IQR]: 13-117). The majority (94.7%) CrAg-positive PLHIV had a baseline CD4+ T cell count ≤ 200 cells/µl. The overall CrAg positivity rate was 5.1%. The CrAg positivity rate among ART-naïve PLHIV was 6.4%, which was similar to that among ART-experienced PLHIV. Notably, within the ART-experienced group, CrAg-positive PLHIV displayed lower baseline and latest CD4+ T cell counts than those in CrAg-negative. CrAg status was significantly associated with shorter ART duration (≤1 year vs. >2 year: adjusted odds ratio [aOR], 2.53; 95% confidence interval [CI], 1.20–5.34. 1-2 year vs. >2 year: 4.61, 2.10-10.12) and other opportunistic infections (2.56, 1.41-4.63) among ART-experienced PLHIV. Among CrAg-positive PLHIV, 44 were diagnosed with cryptococcosis, including 28 previously diagnosed and 16 newly diagnosed cases (8 ART-naïve and 8 ART-experienced).

Discussion

We found a sizable CrAg positivity rate among ART-naïve and ART-experienced PLHIV. A lower baseline CD4+ T cell count was the primary factor associated with CrAg positivity among PLHIV. Serum CrAg screening should be recommended for both ART-naïve and ART-experienced PLHIV with CD4+ T cell counts ≤200 cells/µl.

{"title":"Factors associated with cryptococcal capsular antigen positivity among people living with HIV: A retrospective observational cohort study","authors":"Fenqi Da , Yi Cao , Pengle Guo , Yeyang Zhang , Yaozu He , Quanmin Li , Weiran Tan , Huijun Hou , Xiaoping Tang , Heping Zhao , Linghua Li","doi":"10.1016/j.ijregi.2024.100532","DOIUrl":"10.1016/j.ijregi.2024.100532","url":null,"abstract":"<div><h3>Introduction</h3><div>Cryptococcosis, caused by Cryptococcus, is an aggressive fungal disease posing a high mortality risk among people living with HIV (PLHIV). However, factors associated with the prevalence of cryptococcal capsular antigen (CrAg) among PLHIV remain unclear.</div></div><div><h3>Material and Methods</h3><div>We recruited PLHIV from a designated HIV/AIDS clinic in Southern China between March 2018 and December 2019. Serum CrAg was qualitatively detected using Lateral Flow Assay (LFA). Fungal culture and pathological examinations were performed using the cerebrospinal fluid (CSF). Chi-squared test and multivariable logistic regression were utilized to assess factors associated with the prevalence of CrAg.</div></div><div><h3>Results</h3><div>A total of 1478 PLHIV were included, among whom 297 were antiretroviral therapy-naïve (ART-naïve), 1181 (79.9%) were ART-experienced. The median baseline CD4+ T cell count was 43 cells/µl (interquartile range [IQR]: 13-117). The majority (94.7%) CrAg-positive PLHIV had a baseline CD4+ T cell count ≤ 200 cells/µl. The overall CrAg positivity rate was 5.1%. The CrAg positivity rate among ART-naïve PLHIV was 6.4%, which was similar to that among ART-experienced PLHIV. Notably, within the ART-experienced group, CrAg-positive PLHIV displayed lower baseline and latest CD4+ T cell counts than those in CrAg-negative. CrAg status was significantly associated with shorter ART duration (≤1 year vs. >2 year: adjusted odds ratio [aOR], 2.53; 95% confidence interval [CI], 1.20–5.34. 1-2 year vs. >2 year: 4.61, 2.10-10.12) and other opportunistic infections (2.56, 1.41-4.63) among ART-experienced PLHIV. Among CrAg-positive PLHIV, 44 were diagnosed with cryptococcosis, including 28 previously diagnosed and 16 newly diagnosed cases (8 ART-naïve and 8 ART-experienced).</div></div><div><h3>Discussion</h3><div>We found a sizable CrAg positivity rate among ART-naïve and ART-experienced PLHIV. A lower baseline CD4+ T cell count was the primary factor associated with CrAg positivity among PLHIV. Serum CrAg screening should be recommended for both ART-naïve and ART-experienced PLHIV with CD4+ T cell counts ≤200 cells/µl.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"14 ","pages":"Article 100532"},"PeriodicalIF":1.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Strategy to handle breakthrough HIV infection following PrEP 处理 PrEP 后突破性艾滋病毒感染的策略

IF 1.5 Q4 INFECTIOUS DISEASES

IJID regions

Pub Date : 2025-02-17 DOI: 10.1016/j.ijregi.2024.100528

Anton Pozniak

Pre-exposure prophylaxis (PrEP) is a revolutionary tool in HIV prevention, offering significant protection to individuals at high risk of infection. By taking a daily regimen of antiretroviral medication, users can dramatically reduce their chances of contracting HIV, thereby playing a crucial role in curbing the epidemic and enhancing public health outcomes.

However, the effectiveness of PrEP hinges on correct and consistent usage. Sporadic adherence or premature discontinuation of PrEP, not only diminishes its protective benefits but also poses a significant risk of developing drug-resistant HIV strains. These resistant strains can complicate treatment options and pose a broader public health threat. Emergent CAB-LA resistance recently reported by WHO may impact PrEP strategies.

In the presentation, the experience from public education programs, emphasizing the importance of adherence; running campaigns in partnership with the community; and utilization of technologyto increase awareness. Furthermore, integrating PrEP into broader public health initiatives, such as routine HIV testing and other sexual health educational services can foster a supportive environment that normalizes its use. By addressing the issue of incorrect usage and the associated risk of resistance through education, support, accessibility, and integration, the full potential of PrEP can be harnessed, contributing significantly to the global effort to end the HIV/AIDS epidemic.

{"title":"Strategy to handle breakthrough HIV infection following PrEP","authors":"Anton Pozniak","doi":"10.1016/j.ijregi.2024.100528","DOIUrl":"10.1016/j.ijregi.2024.100528","url":null,"abstract":"<div><div>Pre-exposure prophylaxis (PrEP) is a revolutionary tool in HIV prevention, offering significant protection to individuals at high risk of infection. By taking a daily regimen of antiretroviral medication, users can dramatically reduce their chances of contracting HIV, thereby playing a crucial role in curbing the epidemic and enhancing public health outcomes.</div><div>However, the effectiveness of PrEP hinges on correct and consistent usage. Sporadic adherence or premature discontinuation of PrEP, not only diminishes its protective benefits but also poses a significant risk of developing drug-resistant HIV strains. These resistant strains can complicate treatment options and pose a broader public health threat. Emergent CAB-LA resistance recently reported by WHO may impact PrEP strategies.</div><div>In the presentation, the experience from public education programs, emphasizing the importance of adherence; running campaigns in partnership with the community; and utilization of technologyto increase awareness. Furthermore, integrating PrEP into broader public health initiatives, such as routine HIV testing and other sexual health educational services can foster a supportive environment that normalizes its use. By addressing the issue of incorrect usage and the associated risk of resistance through education, support, accessibility, and integration, the full potential of PrEP can be harnessed, contributing significantly to the global effort to end the HIV/AIDS epidemic.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"14 ","pages":"Article 100528"},"PeriodicalIF":1.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Game theory of pandemic control: Can collaborative vaccine allocation strategies lead to better outcomes?

IF 1.5 Q4 INFECTIOUS DISEASES

IJID regions

Pub Date : 2025-02-17 DOI: 10.1016/j.ijregi.2024.100535

Yiwen Wang , Yang Ye , Xiaoyi Su , Qingpeng Zhang , Hsiang-Yu Yuan

Introduction

Increasing vaccine uptake is an effective way to prevent COVID-19 infection in individual countries after the relaxation of social distancing. However, under the limited vaccine resources, vaccine inequality between high- and low-income countries can also produce more infection and cost. Reducing such inequality relies on a more cooperative (unselfish) strategy, such as vaccine donation from high-income countries, which may initially increase their cost. The study aims to analyze the impact of vaccine inequality on cooperative decision-making between two populations. The results provide important insights on achieving global control of infectious disease outbreaks.

Material and Methods

We developed a transmission model incorporating virus evolution under different vaccine-induced natural selection and the migration to allow a long-term repeated outbreak. Vaccine allocation strategies were implemented between two populations the high vaccine coverage population (HC) and the low coverage population (LC). A game theory approach was employed to explore whether pursuing minimum cost for both sides (cooperative strategy) or itself (non-cooperative strategy) for each population. We estimated the effect of each strategy on the total cost (i.e. the sum of vaccine, hospitalization and labor costs). The Nash equilibrium was obtained by minimizing their own cost for individual countries under different vaccine inequality scenarios (from low to high inequality).

Results

Under low inequality, both populations achieved the same optimal cost with both cooperative and non-cooperative strategies. Under medium or high inequality, both populations reached a Nash equilibrium with non-cooperative strategies and could not reach global optimum. When inequality was high, HC tended towards vaccine donation even though non-cooperative strategies were adopted.

Discussion

When inequality is high, although cooperative decisions can obtain global optimal outcomes, populations tend to choose non-cooperative decisions, increasing extra global costs. The results suggested that effective global control of outbreaks is difficult but vaccine donation can be a win-win strategy.

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引用次数: 0

Age-dependent innate responses to influenza A and B viruses in paediatric and adult primary nasal epithelial cells

IF 1.5 Q4 INFECTIOUS DISEASES

IJID regions

Pub Date : 2025-02-17 DOI: 10.1016/j.ijregi.2024.100533

Tony Chun-Hei Lei , Kin-pong Tao , Joseph Gar-shun Tsun , Genevieve PG Fung , Calvin SH Ng , Kate CC Chan , Paul Kay-sheung Chan , Albert M Li , Renee Wan-yi Chan

Introduction

Age is a major risk factor for influenza infection. The nasal epithelium is the early responder against infectious agents and environmental stimuli by controlling immune cell infiltration and releasing antimicrobial proteins. However, there is a lack of research distinguishing transcriptomic profiles across age upon influenza infection. While age-associated transcriptomic responses to respiratory viruses (e.g. SARS-CoV2, RSV) in lung have been reported, we, thus, hypothesised there are also age-dependent innate responses to influenza in nasal epithelial cells.

Material and Methods

In our study, primary human nasal epithelial cells (HNECs), obtained from healthy paediatric, adult, and elderly groups, were differentiated in air-liquid interface culture before being infected with influenza A and B. The RNA was extracted from cell lysates 48 hours post-infection for bulk RNA sequencing.

Results

Upon influenza A infection, there were 102, 682, and 627 upregulated and 0, 346, and 554 downregulated differentially expressed genes (DEGs) in the paediatric, adult and elderly groups, respectively. Among the upregulated genes, the three groups shared 86 common DEGs, while 320 common DEGs, enriched for more inflammatory and immune responses by cytokine production (e.g., IFN production, IL-17 signalling), were expressed in the adult and elderly groups. Strikingly, influenza A only induced downregulated DEGs in adult and elderly cells, which are associated with microtubule formation and ciliated function.

Fewer DEGs were induced upon influenza B infection, with only 69, 386, and 44 upregulations and 2, 13, and 2 downregulations in the paediatric, adult and elderly groups, respectively. Twenty-seven upregulated DEGs were commonly expressed amongst the three groups, while adults had 310 uniquely expressed DEGs, enriched for stronger immune defence responses against the virus and promoted more anti-viral cytokines (e.g., response to IL-1).

Discussion

Our analyses illuminate avenues for potential therapeutic approaches against influenza in different age groups, leveraging the power of in vitro experimentation.

{"title":"Age-dependent innate responses to influenza A and B viruses in paediatric and adult primary nasal epithelial cells","authors":"Tony Chun-Hei Lei , Kin-pong Tao , Joseph Gar-shun Tsun , Genevieve PG Fung , Calvin SH Ng , Kate CC Chan , Paul Kay-sheung Chan , Albert M Li , Renee Wan-yi Chan","doi":"10.1016/j.ijregi.2024.100533","DOIUrl":"10.1016/j.ijregi.2024.100533","url":null,"abstract":"<div><h3>Introduction</h3><div>Age is a major risk factor for influenza infection. The nasal epithelium is the early responder against infectious agents and environmental stimuli by controlling immune cell infiltration and releasing antimicrobial proteins. However, there is a lack of research distinguishing transcriptomic profiles across age upon influenza infection. While age-associated transcriptomic responses to respiratory viruses (e.g. SARS-CoV2, RSV) in lung have been reported, we, thus, hypothesised there are also age-dependent innate responses to influenza in nasal epithelial cells.</div></div><div><h3>Material and Methods</h3><div>In our study, primary human nasal epithelial cells (HNECs), obtained from healthy paediatric, adult, and elderly groups, were differentiated in air-liquid interface culture before being infected with influenza A and B. The RNA was extracted from cell lysates 48 hours post-infection for bulk RNA sequencing.</div></div><div><h3>Results</h3><div>Upon influenza A infection, there were 102, 682, and 627 upregulated and 0, 346, and 554 downregulated differentially expressed genes (DEGs) in the paediatric, adult and elderly groups, respectively. Among the upregulated genes, the three groups shared 86 common DEGs, while 320 common DEGs, enriched for more inflammatory and immune responses by cytokine production (e.g., IFN production, IL-17 signalling), were expressed in the adult and elderly groups. Strikingly, influenza A only induced downregulated DEGs in adult and elderly cells, which are associated with microtubule formation and ciliated function.</div><div>Fewer DEGs were induced upon influenza B infection, with only 69, 386, and 44 upregulations and 2, 13, and 2 downregulations in the paediatric, adult and elderly groups, respectively. Twenty-seven upregulated DEGs were commonly expressed amongst the three groups, while adults had 310 uniquely expressed DEGs, enriched for stronger immune defence responses against the virus and promoted more anti-viral cytokines (e.g., response to IL-1).</div></div><div><h3>Discussion</h3><div>Our analyses illuminate avenues for potential therapeutic approaches against influenza in different age groups, leveraging the power of in vitro experimentation.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"14 ","pages":"Article 100533"},"PeriodicalIF":1.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Refocusing AMR in the post-COVID-19 era: Challenges and opportunities

IF 1.5 Q4 INFECTIOUS DISEASES

IJID regions

Pub Date : 2025-02-17 DOI: 10.1016/j.ijregi.2024.100523

Edmond Siu-Keung Ma

Antimicrobial Resistance (AMR) has become one of the top global public health issues as declared by the World Health Organization. It has been estimated that there were 4.95 million deaths associated with bacterial AMR in 2019, including 1.27 million deaths attributable to bacterial AMR. The latest global and local situation on AMR would be presented, with focus on rising trends of multi-drug resistance organisms such as Methicillin-resistant Staphylococcus aureus, carbapenem-resistant Acinetobacter, carbapenem-resistant Enterobacteriaceae, and vancomycin-resistant enterococcus. The impact of COVID-19 on AMR, including both antimicrobial utilization and pattern of resistant bacteria would be examined. To combat the AMR pandemic, Hong Kong has launched the second Strategic and Action Plan on AMR which adopts six key strategic areas namely strengthen knowledge through surveillance and research; optimise use of antimicrobials in humans and animals; reduce incidence of infection through effective sanitation, hygiene and preventive measures; improve awareness and understanding of AMR through effective communication, education and training; promote research on AMR; and strengthen partnerships and foster engagement of relevant stakeholders. Positive outcomes have been achieved and new initiatives are underway with ultimate goal to reverse the trends of emergence of AMR in Hong Kong. International collaboration and concerted efforts under the “One Health” approach is essential to tackle the challenges ahead including poor incentives for the pharmaceutical industry to invest in new drug development, risk of AMR in food, and role of the environment in evolution of AMR. Yet, opportunities do exist including sustained effect of non-pharmacological public health interventions, novel anti-bacterial alternatives such as faecal microbiota transplantation and phage therapy, and new financial model for drug development.

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引用次数: 0

Beyond borders: Insights into NTM pulmonary disease's global challenge

IF 1.5 Q4 INFECTIOUS DISEASES

IJID regions

Pub Date : 2025-02-17 DOI: 10.1016/j.ijregi.2024.100524

Albert Yick Hou Lim

The non-tuberculous mycobacterium pulmonary disease (NTM-PD) is a global challenge with increasing prevalence and incidence. Patients with underlying pulmonary diseases, immunocompromised, malignancy, cardiovascular diseases and underweight are at risk of developing NTM-PD. It has significant morbidity and mortality. NTM-PD treatment is complex and inadequate due to drug resistance, drug related side-effects, limited drug options, poor compliance, and low success rate. NTM-PD poses a huge economic burden on health care services and individuals due to frequent exacerbations, significant respiratory symptoms with complications, frequent health care service utilisation and prolonged costly treatment. The prevalence in the elderly population (>65 years) more than doubled over the past 2 decades. The incidence of childhood NTM-PD has increased significantly. The emergence of person to person transmission of M abscessus is highly alarming. The anticipated rise in global ageing, international travelling and climate change necessitate the need to better understand epidemiological trends, clinical consequences, prognostication and better treatment to the global challenge of NTM-PD.

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引用次数: 0

Acceptance and commitment therapy for psychological flexibility, hope and depression among people living with HIV/AIDS: a randomized controlled trial

IF 1.5 Q4 INFECTIOUS DISEASES

IJID regions

Pub Date : 2025-02-17 DOI: 10.1016/j.ijregi.2024.100544

Run Wang, Xianhong Li

Introduction

People living with HIV/AIDS (PLWHA) are vulnerable to mental health problems. Mental health problems among PLWHA adversely impact HIV treatment outcomes and lower their quality of life. The purpose of this study was to investigate the effectiveness of acceptance and commitment therapy (ACT) for hope, psychological flexibility and depression among PLWHA.

Material and Methods

Seventy HIV-infected patients with mild to moderate depressive symptoms were recruited from Designated AIDS Hospital in Changsha City and randomly assigned (1:1) to intervention groups (7 sessions) or control groups (7 sessions). The control group had access to 7 sessions of one-on-one conventional health education about HIV; those in the intervention group were provided with 7 sessions of psychological counseling based on Acceptance and Commitment during 3 months.

Results

The AAQ-II score was lower in the intervention group than in the control group, and the difference was not statistically significant (OR=1.409, 95% CI: 0.075-26.418, P=0.819). Compared with baseline, the AAQ-II scores of the patients in the intervention group showed a decreasing trend over time, and there was a significant decrease in the AAQ-II scores at the end of the 1st month of intervention and at the end of the 3rd month of intervention, and the difference was statistically significant (P<0.05). The intervention group scored higher levels of hope than the control group, and the difference was not statistically significant (OR=0.319, 95% CI: 0.047-2.155, P=0.241). The depression scores in the intervention group were lower than those in the control group, and the difference was not statistically significant (OR=4.055, 95% CI: 0.308-53.366, P=0.287).

Discussion

Acceptance and Commitment Therapy can effectively enhance the psychological flexibility increase the level of hope and reduce depression symptom among PLWHA.

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引用次数: 0